MR. Russell Matthew Wimmer, PA-C

NPI #1912472143 in Lebanon, Oregon

Provider Information

NPI Number: 1912472143
Entity Type: Individual
Name: MR. Russell Matthew Wimmer, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Oct 3, 2018
Last Updated: Nov 4, 2020

Practice Location

Address: 425 N SANTIAM HWY
City: Lebanon
State: Oregon
ZIP Code: 97355-4361
Phone: (541) 451-6960

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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